James Howard Antoszyk, MD

Individual provider Active NPI Ophthalmology Physician · Charlotte, NC

NPI 1508814641 · NPPES record last updated May 3, 2018

Key facts

NPI
1508814641
Entity type
Individual (NPI type 1)
Primary specialty
Ophthalmology Physician 207W00000X
License
96-00165 (NC)
Practice address
6035 Fairview Rd
Charlotte, NC 28210-3256
Phone
(704) 295-3000
Fax
(704) 838-8494
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
96-00165NCMDOphthalmology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 96-00165 NC Yes

Addresses

Primary practice location

6035 Fairview Rd
Charlotte, NC 28210-3256

Mailing address

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

Other identifiers

IdentifierTypeStateIssuer
0494683003OtherNCCIGNA
0841724OtherNCUNITED HEALTHCARE
11626OtherNCBCBS
175006OtherNCCOVENTRY
21855OtherNCPARTNERS
75514OtherNCMEDCOST
8911626MedicaidNC
103936OtherNCWELLNESS
11615OtherNCDOCTORS HEALTH PLAN
376554OtherNCMAMSI
4205345OtherNCAETNA
N08204MedicaidSC
20082699OtherSCSELECT HEALTH OF SC/FIRST CHOICE
773579OtherSCWELLCARE

Other providers in Charlotte, NC

All providers in Charlotte, NC · Ophthalmology Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.